scholarly journals Optimizing e-Consultations to Adolescent Medicine Specialists: Qualitative Synthesis of Feedback From User-Centered Design (Preprint)

2020 ◽  
Author(s):  
Jacquelin Rankine ◽  
Deepika Yeramosu ◽  
Loreta Matheo ◽  
Gina M Sequeira ◽  
Elizabeth Miller ◽  
...  
Keyword(s):  
Primary Care Physicians ◽  
Specialty Care ◽  
Adolescent Medicine ◽  
Second Phase ◽  
User Centered Design ◽  
Qualitative Synthesis ◽  
Care Needs ◽  
Consultation System ◽  
Physician Contact ◽  
User Centered

BACKGROUND e-Consultations between primary care physicians and specialists are a valuable means of improving access to specialty care. Adolescents and young adults (AYAs) face unique challenges in accessing limited adolescent medicine specialty care resources, which contributes to delayed or forgone care. e-Consultations between general pediatricians and adolescent medicine specialists may alleviate these barriers to care. However, the optimal application of this model in adolescent medicine requires careful attention to the nuances of AYA care. OBJECTIVE This study aims to qualitatively analyze feedback obtained during the iterative development of an e-consultation system for communication between general pediatricians and adolescent medicine specialists tailored to the specific health care needs of AYAs. METHODS We conducted an iterative user-centered design and evaluation process in two phases. In the first phase, we created a static e-consultation prototype and storyboards and evaluated them with target users (general pediatricians and adolescent medicine specialists). In the second phase, we incorporated feedback to develop a functional prototype within the electronic health record and again evaluated this with general pediatricians and adolescent medicine specialists. In each phase, general pediatricians and adolescent medicine specialists provided <i>think-aloud</i> feedback during the use of the prototypes and semistructured exit interviews, which was qualitatively analyzed to identify perspectives related to the usefulness and usability of the e-consultation system. RESULTS Both general pediatricians (n=12) and adolescent medicine specialists (n=12) perceived the usefulness of e-consultations for AYA patients, with more varied perceptions of potential usefulness for generalist and adolescent medicine clinicians. General pediatricians and adolescent medicine specialists discussed ways to maximize the usability of e-consultations for AYAs, primarily by improving efficiency (eg, reducing documentation, emphasizing critical information, using autopopulated data fields, and balancing specificity and efficiency through text prompts) and reducing the potential for errors (eg, prompting a review of autopopulated data fields, requiring physician contact information, and prompting explicit discussion of patient communication and confidentiality expectations). Through iterative design, patient history documentation was streamlined, whereas documentation of communication and confidentiality expectations were enhanced. CONCLUSIONS Through an iterative user-centered design process, we identified user perspectives to guide the refinement of an e-consultation system based on general pediatrician and adolescent medicine specialist feedback on usefulness and usability related to the care of AYAs. Qualitative analysis of this feedback revealed both opportunities and risks related to confidentiality, communication, and the use of tailored documentation prompts that should be considered in the development and use of e-consultations with AYAs. CLINICALTRIAL

scholarly journals Optimizing e-Consultations to Adolescent Medicine Specialists: Qualitative Synthesis of Feedback From User-Centered Design

10.2196/25568 ◽  
2021 ◽  
Vol 8 (3) ◽  
pp. e25568
Author(s):  
Jacquelin Rankine ◽  
Deepika Yeramosu ◽  
Loreta Matheo ◽  
Gina M Sequeira ◽  
Elizabeth Miller ◽  
...  
Keyword(s):  
Primary Care Physicians ◽  
Specialty Care ◽  
Adolescent Medicine ◽  
Second Phase ◽  
User Centered Design ◽  
Qualitative Synthesis ◽  
Care Needs ◽  
Consultation System ◽  
Physician Contact ◽  
User Centered

Background e-Consultations between primary care physicians and specialists are a valuable means of improving access to specialty care. Adolescents and young adults (AYAs) face unique challenges in accessing limited adolescent medicine specialty care resources, which contributes to delayed or forgone care. e-Consultations between general pediatricians and adolescent medicine specialists may alleviate these barriers to care. However, the optimal application of this model in adolescent medicine requires careful attention to the nuances of AYA care. Objective This study aims to qualitatively analyze feedback obtained during the iterative development of an e-consultation system for communication between general pediatricians and adolescent medicine specialists tailored to the specific health care needs of AYAs. Methods We conducted an iterative user-centered design and evaluation process in two phases. In the first phase, we created a static e-consultation prototype and storyboards and evaluated them with target users (general pediatricians and adolescent medicine specialists). In the second phase, we incorporated feedback to develop a functional prototype within the electronic health record and again evaluated this with general pediatricians and adolescent medicine specialists. In each phase, general pediatricians and adolescent medicine specialists provided think-aloud feedback during the use of the prototypes and semistructured exit interviews, which was qualitatively analyzed to identify perspectives related to the usefulness and usability of the e-consultation system. Results Both general pediatricians (n=12) and adolescent medicine specialists (n=12) perceived the usefulness of e-consultations for AYA patients, with more varied perceptions of potential usefulness for generalist and adolescent medicine clinicians. General pediatricians and adolescent medicine specialists discussed ways to maximize the usability of e-consultations for AYAs, primarily by improving efficiency (eg, reducing documentation, emphasizing critical information, using autopopulated data fields, and balancing specificity and efficiency through text prompts) and reducing the potential for errors (eg, prompting a review of autopopulated data fields, requiring physician contact information, and prompting explicit discussion of patient communication and confidentiality expectations). Through iterative design, patient history documentation was streamlined, whereas documentation of communication and confidentiality expectations were enhanced. Conclusions Through an iterative user-centered design process, we identified user perspectives to guide the refinement of an e-consultation system based on general pediatrician and adolescent medicine specialist feedback on usefulness and usability related to the care of AYAs. Qualitative analysis of this feedback revealed both opportunities and risks related to confidentiality, communication, and the use of tailored documentation prompts that should be considered in the development and use of e-consultations with AYAs.

scholarly journals Developing Strategies to Reduce Unnecessary Services in Primary Care: Protocol for User-Centered Design Charrettes (Preprint)

2019 ◽  
Author(s):  
Mandi L Klamerus ◽  
Laura J Damschroder ◽  
Jordan B Sparks ◽  
Sarah E Skurla ◽  
Eve A Kerr ◽  
...  
Keyword(s):  
Primary Care ◽  
Design Process ◽  
Phase 1 ◽  
Primary Care Providers ◽  
Medical Services ◽  
Second Phase ◽  
Phase 2 ◽  
User Centered Design ◽  
The Impact ◽  
User Centered

BACKGROUND Overtreatment and overtesting expose patients to unnecessary, wasteful, and potentially harmful care. Reducing overtreatment or overtesting that has become ingrained in current clinical practices and is being delivered on a routine basis will require solutions that incorporate a deep understanding of multiple perspectives, particularly those on the front lines of clinical care: patients and their clinicians. Design approaches are a promising and innovative way to incorporate stakeholder needs, desires, and challenges to develop solutions to complex problems. OBJECTIVE This study aimed (1) to engage patients in a design process to develop high-level deintensification strategies for primary care (ie, strategies for scaling back or stopping routine medical services that more recent evidence reveals are not beneficial) and (2) to engage both patients and primary care providers in further co-design to develop and refine the broad deintensification strategies identified in phase 1. METHODS We engaged stakeholders in design charrettes—intensive workshops in which key stakeholders are brought together to develop creative solutions to a specific problem—focused on deintensification of routine overuse in primary care. We conducted the study in 2 phases: a 6.5-hour design charrette with 2 different groups of patients (phase 1) and a subsequent 4-hour charrette with clinicians and a subgroup of phase 1 patients (phase 2). Both phases included surveys and educational presentations related to deintensification. Phase 1 involved several design activities (mind mapping, business origami, and empathy mapping) to help patients gain a deeper understanding of the individuals involved in deintensification. Following that, we asked participants to review hypothetical scenarios where patients, clinicians, or the broader health system context posed a barrier to deintensification and then to brainstorm solutions. The deintensification themes identified in phase 1 were used to guide phase 2. This second phase primarily involved 1 design activity (<italic>WhoDo</italic>). In this activity, patients and clinicians worked together to develop concrete actions that specific stakeholders could take to support deintensification efforts. This activity included identifying barriers to the actions and approaches to overcoming those barriers. RESULTS A total of 35 patients participated in phase 1, and 9 patients and 7 clinicians participated in phase 2. The analysis of the deintensification strategies and survey data is currently underway. The results are expected to be submitted for publication in early 2020. CONCLUSIONS Health care interventions are frequently developed without input from the people who are most affected. The exclusion of these stakeholders in the design process often influences and limits the impact of the intervention. This study employed design charrettes, guided by a flexible user-centered design model, to bring clinicians and patients with differing backgrounds and with different expectations together to cocreate real-world solutions to the complex issue of deintensifying medical services.

Evaluating User Centered Design of E-Health for Older Adults

2016 ◽  
Vol 1 (2) ◽  
pp. 24-50
Author(s):  
Tracy L. Mitzner ◽  
Katinka Dijkstra
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Technology Acceptance ◽  
Aging In Place ◽  
Health Care Needs ◽  
User Centered Design ◽  
Care Needs ◽  
Older Users ◽  
The Impact ◽  
User Centered

Health care related technology, or E-health, has the potential to lessen the impact of the growing aging population on the health care system and support older adults' preference for aging in place. However, for technologies to be adopted by older users, research is needed to understand older adults' unique health care needs, their preferences for support, and their perceptions of technologies designed for health care. Specifically directed toward older users, this article highlights the need for user-centered design and the implications for technology acceptance, and describes studies that employed systematic subjective methods such as focus groups, interviews, and questionnaires to provide a rich, detailed depiction of older users' interactions with E-health. User-centered design evaluations involving older adults can help designers create products and services that are more likely to be adopted by older adult end users.

Evaluating User-Centered Design of E-Health for Older Adults

2017 ◽  
pp. 338-359
Author(s):  
Tracy L. Mitzner ◽  
Katinka Dijkstra
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Technology Acceptance ◽  
Older Adult ◽  
End Users ◽  
User Centered Design ◽  
Care Needs ◽  
Older Users ◽  
The Impact ◽  
User Centered

Health care related technology, or E-health, has the potential to lessen the impact of the growing aging population on the health care system and support older adults' preference for aging in place. However, for technologies to be adopted by older users, research is needed to understand older adults' unique health care needs, their preferences for support, and their perceptions of technologies designed for health care. Specifically directed toward older users, this article highlights the need for user-centered design and the implications for technology acceptance, and describes studies that employed systematic subjective methods such as focus groups, interviews, and questionnaires to provide a rich, detailed depiction of older users' interactions with E-health. User-centered design evaluations involving older adults can help designers create products and services that are more likely to be adopted by older adult end users.

scholarly journals User-Centered Design of a Web-Based Tool to Support Management of Chemotherapy-Related Toxicities in Cancer Patients (Preprint)

2018 ◽  
Author(s):  
Rebecca M Prince ◽  
Anthony Soung Yee ◽  
Laura Parente ◽  
Katherine A Enright ◽  
Eva Grunfeld ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Health Care Providers ◽  
Primary Care Physicians ◽  
Usability Testing ◽  
Self Management ◽  
User Centered Design ◽  
Care Providers ◽  
Web Based ◽  
Management Advice ◽  
User Centered

BACKGROUND Cancer patients receiving chemotherapy have high symptom needs that can negatively impact quality of life and result in high rates of unplanned acute care visits. Remote monitoring tools may improve symptom management in this patient population. OBJECTIVE This study aimed to design a prototype tool to facilitate remote management of chemotherapy-related toxicities. METHODS User needs were assessed using a participatory, user-centered design methodology that included field observation, interviews, and focus groups, and then analyzed using affinity diagramming. Participants included oncology patients, caregivers, and health care providers (HCPs) including medical oncologists, oncology nurses, primary care physicians, and pharmacists in Ontario, Canada. Overarching themes informed development of a Web-based prototype, which was further refined over 2 rounds of usability testing with end users. RESULTS Overarching themes were derived from needs assessments, which included 14 patients, 1 caregiver, and 12 HCPs. Themes common to both patients and HCPs included gaps and barriers in current systems, need for decision aids, improved communication and options in care delivery, secure access to credible and timely information, and integration into existing systems. In addition, patients identified missed opportunities, care not meeting their needs, feeling overwhelmed and anxious, and wanting to be more empowered. HCPs identified accountability for patient management as an issue. These themes informed development of a Web-based prototype (bridges), which included toxicity tracking, self-management advice, and HCP communication functionalities. Usability testing with 11 patients and 11 HCPs was generally positive; however, identified challenges included tool integration into existing workflows, need for standardized toxicity self-management advice, issues of privacy and consent, and patient-tailored information. CONCLUSIONS Web-based tools integrating just-in-time self-management advice and HCP support into routine care may address gaps in systems for managing chemotherapy-related toxicities. Attention to the integration of new electronic tools into self-care by patients and practice was a strong theme for both patients and HCP participants and is a key issue that needs to be addressed for wide-scale adoption.

scholarly journals Developing Strategies to Reduce Unnecessary Services in Primary Care: Protocol for User-Centered Design Charrettes

10.2196/15618 ◽  
2019 ◽  
Vol 8 (11) ◽  
pp. e15618 ◽  
Author(s):  
Mandi L Klamerus ◽  
Laura J Damschroder ◽  
Jordan B Sparks ◽  
Sarah E Skurla ◽  
Eve A Kerr ◽  
...  
Keyword(s):  
Primary Care ◽  
Design Process ◽  
Phase 1 ◽  
Primary Care Providers ◽  
Medical Services ◽  
Second Phase ◽  
Phase 2 ◽  
User Centered Design ◽  
The Impact ◽  
User Centered

Background Overtreatment and overtesting expose patients to unnecessary, wasteful, and potentially harmful care. Reducing overtreatment or overtesting that has become ingrained in current clinical practices and is being delivered on a routine basis will require solutions that incorporate a deep understanding of multiple perspectives, particularly those on the front lines of clinical care: patients and their clinicians. Design approaches are a promising and innovative way to incorporate stakeholder needs, desires, and challenges to develop solutions to complex problems. Objective This study aimed (1) to engage patients in a design process to develop high-level deintensification strategies for primary care (ie, strategies for scaling back or stopping routine medical services that more recent evidence reveals are not beneficial) and (2) to engage both patients and primary care providers in further co-design to develop and refine the broad deintensification strategies identified in phase 1. Methods We engaged stakeholders in design charrettes—intensive workshops in which key stakeholders are brought together to develop creative solutions to a specific problem—focused on deintensification of routine overuse in primary care. We conducted the study in 2 phases: a 6.5-hour design charrette with 2 different groups of patients (phase 1) and a subsequent 4-hour charrette with clinicians and a subgroup of phase 1 patients (phase 2). Both phases included surveys and educational presentations related to deintensification. Phase 1 involved several design activities (mind mapping, business origami, and empathy mapping) to help patients gain a deeper understanding of the individuals involved in deintensification. Following that, we asked participants to review hypothetical scenarios where patients, clinicians, or the broader health system context posed a barrier to deintensification and then to brainstorm solutions. The deintensification themes identified in phase 1 were used to guide phase 2. This second phase primarily involved 1 design activity (WhoDo). In this activity, patients and clinicians worked together to develop concrete actions that specific stakeholders could take to support deintensification efforts. This activity included identifying barriers to the actions and approaches to overcoming those barriers. Results A total of 35 patients participated in phase 1, and 9 patients and 7 clinicians participated in phase 2. The analysis of the deintensification strategies and survey data is currently underway. The results are expected to be submitted for publication in early 2020. Conclusions Health care interventions are frequently developed without input from the people who are most affected. The exclusion of these stakeholders in the design process often influences and limits the impact of the intervention. This study employed design charrettes, guided by a flexible user-centered design model, to bring clinicians and patients with differing backgrounds and with different expectations together to cocreate real-world solutions to the complex issue of deintensifying medical services. International Registered Report Identifier (IRRID) RR1-10.2196/15618

Rancangan Lowongan Kerja Online Menggunakan Metode User Centered Design (Studi Kasus: Business Placement Center STMIK AMIKOM Yogyakarta)

2016 ◽  
Vol 3 (1) ◽  
pp. 62
Author(s):  
Rhomita Sari ◽  
Ema Utami ◽  
Armadyah Amborowati
Keyword(s):  
Research Methodology ◽  
Design Approach ◽  
User Centered Design ◽  
Analysis And Design ◽  
Job Vacancy ◽  
Placement Center ◽  
User Centered

Business Placement Center membantu mengelola website alumni dalam memenuhi kebutuhan alumni salah satunya memberikan informasi mengenai lowongan pekerjaan. Website Alumni Amikom sudah memberikan informasi mengenai lowongan pekerjaan. Namun website alumni masih perlu ditambahkan fitur-fitur menu penunjang dalam mempermudah pencarian informasi pekerjaan yang sesuai keinginan pengguna. Penggunaan metode User Centered Design untuk mempermudah pengguna dalam menggunakan fasilitas yang ada pada website ketika mencari informasi lowongan pekerjaan dan pengguna berperan penting dalam setiap proses UCD. Dengan pendekatan User Centered Design diharapkan dapat menghasilkan tampilan dan fungsionalitas yang maksimal pada rancangan sistem yang dibangun sehingga sesuai dengan kebutuhan pengguna. Metode penelitian yang dilakukan yaitu observasi, wawancara dan kuesioner untuk mengetahui kebutuhan pengguna. Analisis dan perancangan menggunakan pendekatan User Centered Design dan implementasi perancangan sistem. Hasil penelitiannya adalah pengguna merasa nyaman dengan tampilan antarmuka website yang sudah dibangun, informasi yang disajikan mudah dipahami dan fitur-fitur menu sudah berhasil berjalansesuai fungsi.Business Placement Center help manage the website for the needs of alumnus one of them is to provide information on a vacancy. The alumnus website’s provides information about job vacancy. The website still need the support to facilitate the searching all the features the work in accordance with what the use. The method of user centered design to make it easy for users in the use of the existing facilities at the website while searching for information a vacancy and users play an important role in any proses UCD. User Centered Design approach is expected to produce the interface and functionality maximal built in the system so that in accordance with the need of users. Research methodology was by observation, interviews and quesionnaires to find out the need of users. Analysis and design using UCD approach and implementation of the system. The results of research is users feel comfortable with a display interface of website which have been built, the information is easily understood and menu features has been successfully run a function.

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